Category Archives: Phases Skin Care

Nearly twenty years ago, Dr. Turkle established an aesthetics department within our surgical practice because she realized there are some problems that are better handled with less invasive treatment. In addition, it is her belief that there are many products and treatments that really work and that can delay the need for surgery or prolong one’s investment in surgery.

Your skin can’t glow if it is unhealthy, sun-damaged or aging. Professional skin care treatments and products can clean dead skin cells and debris from your skin, reduce pore size, reduce redness and hyperpigmentation, reduce fine lines and wrinkles, tighten lax skin, reduce hair and more. More complex problems such as rosacea and extremely sensitive skin can be treated as well.

Just as important is that skin care products that really work contain more active ingredients and penetrate more deeply into the skin than those you buy over-the-counter.

The licensed medical aestheticians at Phases Skin Care and Laser Center are the best trained and best qualified professionals in the state. They are specifically trained to function in a medical setting, under the supervision of board-certified plastic surgeons, to offer advanced therapies and the latest in aesthetic treatments and products. They receive regular continuing education to keep them up-to-date on the latest developments in their field.

We take pride in developing a personalized skin care treatment and product regimen for you. Whether you are interested in skin rejuvenation and resurfacing, skin tightening, body sculpting, facials, peels, laser hair removal or other services, your first step is to schedule an aesthetics consultation to discuss your needs, your goals and your timeline. Whether your skin has special needs or not, you will benefit from the expertise and experience of our medical aestheticians.

Do you struggle with stubborn fat deposits? Whether it’s a muffin top, saddlebags or stubborn fat under your chin- the experts at Phases can help!

At Turkle & Associates, we pride ourselves on cutting-edge technology. While liposuction is an amazing way to treat stubborn fat deposits, not everyone is interested in going under the knife. Coolsculpting and truSculpt are both amazing alternatives to liposuction.

No surgery. No downtime. Unmistakable results.

Turkle & Associates was one of the first offices locally to offer Coolsculpting – an FDA-approved non-invasive treatment that freezes fat (known as cryolipolysis). Coolsculpting has gained national attention and has quickly become the go-to alternative to liposuction. With customized applicators for different body areas, the Phases staff can truly “sculpt” the fat away.

Based on the current Coolsculpting applicators, we can effectively treat the abdomen, love handles, inner and outer thighs, bra fat and back fat. Clinical studies of Coolsculpting show a reduction of 20-30% per treatment.

Coolsculpting sounds great- but what about truSculpt?

truSculpt is also FDA-approved for fat reduction, but adds skin tightening and textural improvements to its repertoire. While Coolsculpting uses cold to get rid of fat, truSculpt utilizes radiofrequency. The great thing about radiofrequency wavelengths is that they also help with skin laxity and texture.

Also, because the Phases staff utilize a handpiece to offer truSculpt, the area to be treated does not have to be “pinchable.” Common treatment sites for truSculpt include: abdomen, love handles, inner thighs, knee fat, arms, bra fat and submental (double chins).

How do I decide between Coolsculpting and truSculpt?

They both work – now what? The great news is, the Phases staff will customize a treatment plan to YOU. After an in-depth assesment, we will create a plan that will address all of your body concerns.
Coolsculpting is ideal for areas that are “pinchable.” Based on Coolsculpting’s technology, the more adipose tissue (fat) we can recruit into the applicator, the better. If your skin still has a lot of elasticity (otherwise known as snap-back) then Coolsculpting by itself may address your concerns.

If your skin stretched quite a bit with your pregnancy or weight fluctuations and you are not interested in a tummy tuck, a combination of Coolsculpting and truSculpt may make the most sense. Because truSculpt uses Radio-frequency technology, it improves skin’s texture – allowing it to address the wavy texture many women have after childbirth.

Seeing less of yourself? That’s just the beginning!

As if our before and after pictures and knowledgeable staff weren’t enough – Phases patients that have received Coolsculpting and truSculpt almost always return to treat other areas. Often, patients will address their abdominal area initially. and then return to treat bra fat, underarm fat or inner thigh texture.

Microneedling. It sounds scary. Almost like acupuncture for your face, right? We have had many patients that are interested in the benefits of microneedling – collagen stimulation, an improvement in acne scars, fine lines and texture, etc., but who are scared that it may hurt or have quite a bit of downtime.

While watching the MDPen microneedling procedure at Phases, I was intrigued. Initially, Ashli, one of the medical aestheticians, applied numbing cream to her patient. She then very meticulously covered her patient’s cheeks with the microneedling device, moved to her chin, to her other cheek and then up to her forehead. The patient was chatty at first and then ended up falling asleep.

Upon following up with Ashli’s patient, I learned that she had some pinkness for the day of and after she had her MDPen procedure, got a little dry a few days after that, and then started getting multiple compliments on her “glow” at about the 5 day mark. Sign me up!

Being in the industry for almost 12 years, I knew that microneedling was a tried and true procedure. It gained a lot of popularity prior to fractionated lasers, and now has resurged as an alternative to laser treatments for those who needed maintenance or cannot afford a full laser package.

To learn more about microneedling or any of the services or products offered by Phases, please click here to contact Phases Skin Care & Laser Center in Indianapolis by using our quick contact form or call us at 317-848-8101 today.

It’s the time of year when spring can’t come fast enough. Just when you think winter is finally finished, you wake to frost on the ground. And like us, you’re probably ready for an end to winter skin – being dry, flaky, red and itchy is as fun as trekking through freezing rain.

Though we can’t make warm days arrive sooner, there are easy steps to soothe skin and get it ready for spring.

1) Upgrade your moisturizer. Opt for an antioxidant-packed, emollient hydrator. For dry, aging skin we recommend SkinMedica’s Dermal Repair Cream or TNS Ceramide Treatment Cream if you’re dry and redness-prone. Patients with oily skin – or those who simply prefer a lighter moisturizer – will love Skinprint’s B5 Bloom. This silky gel uses a high amount of sodium hyaluronate (similar to hyaluronic acid) to plump and hydrate skin without occlusion.

2) Turn down the thermostat. We know it’s tempting to turn the dial way up when it’s bone-chilling. But dry heat sucks moisture from skin and hair – which is no good when you’re already dehydrated. Bonus: You’ll save money on energy bills!

3) Cleanse your face the right way – ditch the bar soap. Soap can be drying, and in areas with hard water, like Indianapolis, soap mixes with mineral deposits to form scum. A fine layer of it can stay on skin, causing irritation and clogged pores. Opt for a gentle, water soluble cleanser like SkinMedica’s Facial Cleanser or Skinprint’s Sensitive Skin Cleanser.

4) Schedule a facial plus dermaplaning with one of our estheticians at Phases skincare center. Exfoliation is especially important this time of year as skin cells turnover slower during colder months. With dermaplaning, a small razor is brushed gently across the face to remove vellus hair (aka peach fuzz) and dead skin cells. This quick process leaves skin so soft and smooth. You may find that your anti-aging serum absorbs better. To really glow, follow dermaplaning with a gentle chemical peel!

5) If your skin has really taken a beating from winter weather, a deeper treatment might work best for you. Schedule a consultation with an aesthetician at Phases Skin & Laser Center and we’ll work with you to find a treatment that will get your skin glowing for the Spring!

Treating Late Winter Skin was last modified: February 7th, 2018 by admin

Welcome back! I hope you’ve had a good summer. I can’t believe it’s coming to a close. Just a few more weeks of BBQs, weekends at the lake and splashing around the pool. I’ve touched on acne over the last few months, so let’s talk about something new.

Let’s go back to the basics of skincare for ALL skin types and conditions and why it is so important. First, it helps with its function. Our skin is the largest living organ of the body, so it has a very big job of keeping what’s inside protected. Therefore, it deserves care to keep it healthy and working properly. By cleansing, you’re removing the buildup of cells which can dull the complexion. Think of a brand new car, shiny and sparkling. Cleanse your skin and it will stay glowing, just like your new car’s paint!

Now we need to hydrate the skin so it can breathe (remember, it’s living). You can use a cream or a lotion to add moisture to the skin and keep it plumped up and healthy. Let’s think of those tires on the car. Maybe the rubber is a little dull and dried out. Putting a little oil on them makes them supple, just like you’d want your skin to be!

For the final step, let’s protect the skin with an SPF. Back to the car and it’s windows, they do have a little UV protection (especially if they’re tinted). Applying a broad-spectrum SPF can protect your skin from the sun’s harmful rays, just like the window tint. There are powder and cream sunscreen options available. Some of my favorites are the new tinted sunscreens from SkinMedica and Sunforgettable mineral sunscreen from Colorescience.

This study patient’s forehead looks considerably younger after regular BBL treatments than it did 12 years ago when he began treatment. What if there was a treatment that could turn back the hands of time and keep you forever young? Scientific studies have shown that regular maintenance treatments using Forever Young BBL rejuvenates the skin and delays skin aging. BBL (Broadband Light) is a light based treatment that provides targeted treatment for many skin conditions caused by aging and sun exposure, such as freckles, age and sun spots and skin redness, as well as small facial veins, acne, skin firmness and uneven skin texture.

The light energy generated by BBL heats the upper layers of your skin and stimulates your skin cells to regenerate new collagen. Any area of the body can be treated. The most popular areas are the face, neck, back of the hands, chest and shoulders. The treatment is gentle, non-invasive and FDA-cleared.

A Stanford University study showed that regular BBL treatments can restore gene expression patterns of aged human skin to resemble young skin, which
improved fine wrinkles and pigmentation.

Another study showed BBL halts the visible signs of aging. In this study, BBL patients appeared nine years younger than their actual age when evaluated by a panel of physicians. The conclusion of this study was that a regular regimen of BBL treatments annually can reduce and delay the long term signs of skin aging.

The photos above are of a study patient. The first was taken 12 years ago. The second, or after photo, was taken during the study after a series of regular BBL treatments each year. After 12 years of BBL treatment the patient’s skin looks younger than it did 12 years earlier!

We hope your summer has been fun and you’re gearing up for Fourth of July celebrations at home or at the lake house. It’s hard to believe school will be starting soon and summer will be a distant memory.

There are some things that we would LOVE to have as distant memories (old boyfriends, gum on our shoe and bad hair days come to mind), but acne and acne scars are probably at the top of most peoples lists. There are so many options available for treating and, eventually, eliminating those pesky pimples and we want to help! Phases™ aestheticians are the most knowledgeable and truly caring about helping you, your teen and your friends with the right information to create a plan to tackle it for good!

Skincare products are the foundation of a good plan. Couple it with a chemical peel and/or BLU-U light and you will be on your way to clearer skin before the first leaves fall of the trees. For some more options, one of our many lasers can work to smooth out what the acne left behind.

We invite you to come in to let us help start your journey to clear skin!

To learn more about attacking acne or any of the services offered call us at 317-848-8101 today.

Do you have “tattoo regret”? Recent studies estimate that 20 percent of Americans with at least one tattoo regret their decision. Maybe it was just on a whim with a friend on vacation or an expression of love for someone that is no longer in your life, but you don’t have to be stuck with the memory in ink. Just start fresh with PicoSure, the world’s only picosecond aesthetic laser for tattoo removal, which effectively erases tattoos with fewer treatments and better results. Even tattoos that have been treated previously but failed to clear can be removed with PicoSure’s patented PressureWave™ technology.

An unparalleled breakthrough in tattoo removal technology, PicoSure gently delivers ultra-short pulses of energy to the tattoo ink in trillionths of a second without injury to the surrounding skin. This shatters the ink into tiny particles that are easily eliminated by the body. Based on physician studies, PicoSure has proven effective on difficult ink colors, as well as previously-treated tattoos, for better removal with fewer treatments.

Our aestheticians at Phases Skin Care and Laser Center are experienced in treating you with the utmost care and will give you an honest expectation of how many treatments it will take to be free and clear of the reminder! Best of all, our medical staff can give you an anesthetic block so the treatment is virtually pain free! If you’d like to know more, watch or record Indy Style on WISH-TV8 on Tuesday, June 10th at 9:00 a.m. when Dr. Turkle demonstrates tattoo removal with PicoSure.

May in Indy is full of flowers, the Indy 500, Memorial Day and the end of the school year. It is the month when we celebrate Moms (shouldn’t we ALWAYS celebrate them?).

If you are a mom, an aunt, a sister or a friend, you have probably seen or heard a teen lament about it. They suffer from it and it can be hard for them to know how to take care of it and get rid of it. What is it? Acne. That four-letter word. That thing that you hope no one else sees, so you try to disguise it with bangs, concealers and hats. Look no further than Phases Skin Care and Laser Center and our aestheticians with an extensive knowledge of how to treat the teen acne patient. They have every tool you could imagine to create a plan to help you and your teen get it cleared up before heading back to school in the fall. Skincare? Yes. Chemical peels? You bet. Laser treatments? Of course.

To learn more about teen acne or any of the services offered by Phases, please click here to contact Phases Skin Care & Laser Center in Indianapolis by using our quick contact form or call us at 317-848-8101 today. Let us help you and your teen feel better with clear, acne-free skin.

Spring is here! I hope you are enjoying the buds on the trees and the flowers peeking up through the mulch. Spring is a time of renewal and it’s a great time to think about summer! Pools, boats, beaches and bathing suits. Sunglasses, sunhats, SPF and shaving. Wait, shaving? Well, toss your razors and depilatories because laser hair removal is your new best friend and we have the right ones to treat everyone – men, women, fair skin, dark skin and even tanned skin! This is the best time to get your treatments, as it takes around 5-8 sessions to see the best results. Our licensed aestheticians at Phases Skincare and Laser Center have extensive knowledge about how to best treat ALL skins, how to prep before treatments and what to expect afterwards. Facial areas such as upper lip, chin, beard and neck can be treated every 4 weeks. Body areas such as bikini line, underarms, legs and backs can be treated every 6 weeks.

In a hurry? No worry – we have a laser that can treat a men’s back in around 10 minutes! Don’t go another summer wishing you had started this year, feel confident all year long having treated yourself to the beauty of laser hair removal.

Spring is (hopefully) upon us and we have talked about the SkinMedica LYTERA Brightening System and chemical peels the past couple months. This month I would like to talk about retinols. There are many myths on why to use them, what to use (or NOT to use) with them and how they really work. We have several to choose from at Turkle & Associates and Phases™ Skincare and Laser Center, so let’s go over a few basics.

First, why would I use a retinol? The simplest answer is that it is an antioxidant that “talks” to the cells and tells them to make more healthy, young cells. It is Vitamin A, for anti-aging and can also help with acne. It “ramps up” the production of new skin cells. This is a key factor in the skin not only acting younger, but looking younger too! They really give you a glow (and who wouldn’t want that?). Everyone can use a retinol; it’s just finding the right one for your skin.

Second, what can I use (or NOT use) with them? It is important to use an SPF 30 whether or not you use a retinol, but especially important is to use other antioxidants, like Vitamin C and E, with your retinol.

Vitamin C requires a low pH to remain stable. Retinol works best in an acidic environment (and skin is naturally more acidic than neutral) therefore, the two work beautifully together to fight free radicals. In fact, your Vitamin C helps keep the retinol from oxidizing and allows it to penetrate deeper into the skin. Magic, right? Science AND magic! How about those AHA’s (alpha-hydroxy acids) and BHA’s (beta-hydroxy acids) you hear so much about? Can you still use those with your retinol and other antioxidants? Absolutely! In fact, when used together they improve the results you get from both.

Lastly, how do they work? Keep in mind, you don’t have to deal with peeling, flaking and redness with retinol use. Retinols work by penetrating deeper into the skin and converting to retinoic acid. If you experience irritation, you should stop using for a few days and hydrate the irritated skin to soothe it and bring it back to “normal”. You can (and should) use a moisturizer as a part of your regular skincare program-but especially when using a retinol.

I hope this has helped dispel some of the myths about retinols. We have several different brands and strengths of retinols to help you on your journey to healthy, glowing skin.

The New Year usually brings thoughts of resolutions; some of them attainable and some, well…better luck next year. A very achievable goal is brighter skin! There are a few simple things you can start today that will make a dramatic improvement in your complexion.

Dr. Turkle has had the LYTERA Skin Brightening System by SkinMedica for several months and has seen very impressive results with daily use. The system is a simple cleanser, LYTERA Skin Brightening Complex, a retinol and a sunscreen. Clinical studies saw improvements after four weeks and 100 percent patient satisfaction in a long-term study of twice-daily use. If hyperpigmentation, melasma, “pregnancy mask” or sun and age spots have you down, call us to see if the LYTERA Skin Brightening System is right for you.

LYTERA was recently named by New Beauty magazine the “Best Dark Spot Remover” product! Our licensed medical aestheticians at Phases can help you with a series of chemical peels, too.

We have three types of SkinMedica peels: Illuminize, Vitalize or Rejuvenize. Before having a peel, please stop using any Retinol product (OTC or Rx). Depending on the amount of “peeling” you desire and the degree of imperfections you want corrected, we can guide you in choosing the peel that is right for you that day. Please note that all peels are best done in a series of 3-6 for the most compelling results.

The Illuminize Peel is a great “starter” peel. It gives you a nice glow, is great for mild imperfections, teens and can be performed every 2 weeks. You may not actually “peel” from this one, so if you don’t want any downtime, this one’s for you!

The Vitalize Peel is for a little more “peel”- with the peeling lasting 2-5 days. Great for melasma, acne and more moderate imperfections, this peel can be done every 2-4 weeks. Great results for just a tad more downtime.

The Rejuvenize Peel is for that true “peel” – with the peeling lasting 3-5 days. Great for acne scarring, severe imperfections and sun damage, this peel can be done every 4-6 weeks. You should definitely get peeling from this one – so get ready to peel!

As you can see, we have a peel for everyone! It’s a New Year, so why not celebrate by peeling away last year and revealing glowing skin in the new year?

Approved by the FDA in 2008 for eyelash growth, our friends at Allergan will begin testing LATISSE for growing hair on the scalp. The clinical trial will determine if LATISSE is effective for male and female pattern baldness, types of alopecia. If LATISSE proves effective, it is reported that it would most likely be sold as a cream that could be applied to the scalp. We have no idea what that might cost but it is a potential treatment for many of our patients, male and female, who experience hair loss. Of course, it could be many years before the product actually makes it to the market. Stay tuned.

Janet Valasek, a recently turned 50-year-old, was one of the three women chosen by After40 magazine and Turkle & Associates to participate in a rejuvenation opportunity. Janet works at a local law firm, is single and a breast cancer survivor. Turkle & Associates and Phases Skin Care and Laser Center are providing skin rejuvenation and other services to Janet. Last week she began work with Cindy Sams of Full-Body Fitness, one of our Girls’ Night Out Indy makeover partners. I thought you would enjoy reading Cindy’s and Janet’s blogs from their first sessions. – Dr. Jan Turkle

Janet’s Initial Comments from her Fitness Assessment: Very First Day with FBF/Cindy

My new trainer is Cindy Sams! The same Cindy (with the ball) that I had seen in the Fishers magazines! She was going to be MY trainer and I was going to be her GNO woman! Judy and staff were determined to pair up the two of us and they got it DONE and I am just so thrilled and grateful!!!

And not a day too soon apparently!!! On Saturday, I met with Cindy and received my initial assessment! We discussed my present workout routine (non-existent), my eating habits, discussed my goals and performed a physical assessment and yes…the dreaded photos! Whoa, wake up call!!! 31% body fat, did she just say that?!!! I mean… REALLY???

We talked a great deal about nutrition and my eating habits and I tried to come up with some reasonable explanation for my eating habits, throwing around a few healthy food habits to impress her like ‘I only eat vegetable pizzas’, ‘I don’t eat an entire bag of cookies or chips in a single sitting’, but the end result was that we determined that I am eating what most 4-20-something year olds eat (worse really) and the quantity of that of a ‘M-A-N’!!! LOL!!! It was a real eye opener for both of us and none of it ‘washed’ with Cindy!!!

Cindy put together a healthy eating program for me on the spot which involved an immediate trip to the grocery store! No ridiculous foods I’ve never heard of, no special trips to Trader Joe’s or Good Earth for organic foods…just plain, simple everyday snacks and grilled foods which I happen to love! Loads of tips for preparing my meals a week ahead on weekends so I have healthy foods to eat throughout the upcoming week! And simply cutting my portions in half, what a novel idea!!! LOL!!!

Cindy then discussed a workout routine that only requires 30 minutes a day; I can do 30 minutes a day in my sleep!!! We determined my fat burning zone which allows me to work out in a decent pace that will not leave me gasping for air and severe lactic acid muscle burn. Just a nice, easy pace that gets my muscles moving and my blood flowing.

Cindy is a ‘really serious’ trainer, all warm, pretty and funny on the outside, but on the inside, this women means business when it comes to fitness which I learned really quickly! We did about 20 minutes of training my first day. Cindy focuses on the fundamentals and the core muscles – short, intensely-focused workouts!

I didn’t go home huffing, puffing and sweating, however that evening, I was feeling it deep in the muscles in places I didn’t realize we had actually worked on!

So I’m totally committed going forward and feel as though I can accomplish my goals with coaching and discipline!

Alright! It’s been almost a week since I met with Janet for her fitness assessment. I sent her on her way with two things she needed to start working on right away: 1) 4 days of cardio (In her fat burn zone) for 30 minutes each; and 2) starting eating the way we discussed at her F.A.

As she was warming on my elliptical for 10 minutes (in her zone!) we chatted about these things. Janet had been out of town on business but got some runs in and ate great except for one day (she said). I always like people to tell me what their “not so great eating” days are. They never are as bad as they think! (thankfully!) 🙂 Eating at Ruth’s Chris… well, what can I say?! You can never go wrong there! So a few bites of some shrimp on top of some mashed garlic potatoes… not so bad!

I reminded her that I want the 4 days at 30 min. each in her ZONE and if she wants to “run” do it on the other days. Briefly, doing cardio in a lower heart rate zone burns your body fat as fuel AND helps you GAIN lung capacity.

She’s doing great on the eating. Keep it up girlfriend! First step is to be AWARE of how you WERE doing and how little you really need to “suffer” to lose weight! 😉

I reminded her to keep stretching those muscles… constantly! Especially her hamstrings!

Janet gets in a full 3 days with me next week so I’ll chat back with you then. We’ll also be reweighing her then, but no body fat or circumference measurements until 30 days! So stay tuned!

Love ya! Cindy 🙂 – Cindy Sams

Janet Valasek

The healthy eating has begun and I have not felt like I was starving! Although my evenings are my most difficult time as I get PRETTY hungry after 7 pm but mostly just thoughts of grazing and not real ‘hunger’ which Cindy assures me will get easier as I change my foods and routine!

I had quite a challenge my first week, first a work luncheon with ‘the girls’ and then I had to go out of town. First, I survived the luncheon at Bucca with different food choices than my past routine! Opted for the chicken breast with capers instead of the Lasagna, green beans substitute for the side of linguini, skipped the bread (although Cindy’s says it’s not a requirement to pass up everything) – just moderation!

I got a lot of comments this week like ‘oh go ahead and eat it, you can start on your program tomorrow !’ I had two people tell me that on two different days so I get it that this was part of my on-going problem of always ‘starting tomorrow’ for every special occasion!

Then onto Atlanta, GA for two days of work and two days of visiting with my best friend, Carol Speer-Adamec and her family. Carol threw a little 50th birthday celebration for me with her family, but hallelujah…there was not fattening cheese dips, burgers or birthday cake!

We all ate from a big vegetable platter of healthy foods, fresh fruit, chicken salad (which I declined) and in place of a birthday cake, she made me a watermelon cake which I found out was not cake at all but a small, chilled watermelon with a BIG 50 – no cake, no icing, no ice cream!

And two days of short jogs, long walks outdoors in the sunshine (in my shorts) was just the thing to remind me… summer is like…. four short weeks away!!! Gotta get in shape NOW!!!

I made it through my first week, a few slips but this was the exception to the rule and surprisingly enough, it was not at all painful and I didn’t starve to death as I sure I might! LOL!!! Drama Queen!!!

Cindy coached me at the start of the week that I would have aha moments and missteps and assured me the overall program would more than make up for a few weak moments. This took a lot of the pressure off and gave me the confidence that I could do this!

Starting week two, gotta run to the store and see what I can whip up – Janet Valasek

Girls’ Night Out Makeover Participant Begins Work with Trainer was last modified: February 9th, 2018 by admin

As we move into the longer and brighter days of spring and summer, we need to think about protecting our skin from the UV rays. Ultraviolet radiation exposure is the primary cause of skin cancer, wrinkles and irregular pigmentation. There is a death every hour in the U.S. due to melanoma (over 8000/yr). Of all of the skin care advice given, proper protection from the sun will make the greatest difference in one’s future appearance. All the money spent on all the cosmetic products and procedures is wasted if one does not employ good “sun sense.” Avoidance of sun exposure during the 10 am to 4 pm period and wearing sun protective hats and clothing will help. Daily use of sunscreen is also an important part of helping to protect ourselves from damaging UV rays. Anyone over six months of age should use a sunscreen daily and children under six months should not be exposed to the sun.

Much confusion surrounds Sun Protection Factor (SPF) ratings. In short, SPF is a measure of how much the product shields the sun’s shorter-wave ultraviolet B rays (known as UVB radiation). UVB is known to produce sunburn and was found to cause squamous cell cancer. The first sunscreens developed were aimed at improving UVB protection. An SPF of 15 is supposed to allow one to be protected 15 times longer from burning from the sun’s rays than unprotected. Unfortunately, this is misleading due to the fact that very few people wear the sunscreen as heavily as is tested in the laboratory. It is estimated that we are usually receiving about one third of the protection because we wear about one half as much as the sunscreen needed. An adult needs about 30 cc or 1 ounce to cover their body as the manufacturers have tested the product. The “two finger” rule indicates that one needs two finger lengths of sunscreen applied to all 11 parts of the body (each arm, each upper leg, lower leg, upper back, lower back, head/neck, etc).

The sunscreen needs to be applied 20-30 minutes prior to sun exposure and reapplied every two hours (or more often if sweating or in the water). “Water resistant” sunscreens indicate about 40 minutes of protection and “very water resistant” (water proof is no longer allowed on the label) indicate about 80 minutes of protection. The higher the SPF doesn’t always tell the entire story. An SPF 15 blocks approximately 94% of the sun’s UVB rays. SPF’s of 30 and 50 block 97% and 98% respectively. Insect repellents reduce the effectiveness of sunscreen by about one-third so if you are using an insect repellent and sunscreen together, use a higher SPF and reapply your sunscreen more frequently.

UVA rays are more penetrating than the UVB rays. They penetrate deeper into the skin’s layers and are thought to be more responsible for DNA damage and aging. The U.S. does not have a rating system for UVA protection as yet. The Japanese system of PA+ to PA++++ is a system that one will often see for UVA protection ratings on some products. One + is very poor UVA protection, while four + is high protection. UVA rays penetrate glass and do not seem to be blocked by cloud cover as much as UVB. These are the rays that we should protect against year round and are the basis for promoting the idea that sunscreen should be worn 365 days a year. Agents that block UVA rays are either chemical or physical blocking agents. Many of the chemical blocks degrade rapidly in the sun and have to be stabilized. Physical blocks such as zinc and titanium dioxides do not degrade and reflect the sun’s rays. Avobenzone and ecamsule are two examples of chemical sunscreens that block UVA rays. Avobenzone rapidly degrades in the sun and requires stabilization (Helioplex). These agents are absorbed into the skin and transform UV radiation into heat energy. The physical sunscreens reflect and refract the rays.

The Bottom Line on Sunscreens

Sun protection needs to occur year round

Use a sunscreen with at least an SPF 15 and one with adequate UVA coverage

Ninety-eight percent of us have dehydrated skin. Even those who believe they have oily skin can be dehydrated. You can tell if dehydration is an issue for you if you have areas of flaky skin, skin tightness, blotchy or reddened areas, a dull complexion, difficulty in applying makeup or adult acne. Those with oily skin still need a good moisturizer. Moisturizers come in many types and price points. A good moisturizer needs to be able to maintain the protective barrier of the skin. Ingredients that protect the skin from free radical damage, retain moisture in the cell, limit irritation and enhance healthy cell production need to be part of a good moisturizer. Drier skin types might do well with a lotion or cream based formula, such as SkinCeuticals Hydrating B5 Gel or iS Clinical PolyVitamin. Those with oily or blemish prone skin might benefit from a hydrating serum like Replenish Night Renewal, SkinCeuticals A.G.E. Interrupter or iS Clinical Youth. Your aesthetician can recommend which one is best for you. All of these products are available at Phases Skin Care and Laser Center.

Another excellent moisturizing product is a Purigenex mask. This is a collagen mask with a serum base that works well with all skin types. The mask is very hydrating and the benefits can be seen and felt immediately. It works well for anyone who wants to prevent and repair their skin from aging, sun damage, discoloration and acne scarring. Regular use boosts the skin’s own collagen and makes it appear plumper, smoother, more supple and more youthful. Our aestheticians recommend application of a Purigenex mask following a Vibradermabrasion facial.

As we age, skin tends to be drier and the dead cells cling to the surface, giving the skin a rougher texture. When we shed those dead cells with a scrub or peel, it enhances the functioning of the skin. The water retaining cells come to the surface and allow the active ingredients in one’s skin care – like retinoids and anti-oxidants – to penetrate better. Vibradermabrasion is a way to remove approximately 90% of the stratum corneum (or the outer layer of dead skin cells). This is a very gentle technique available at Phases, that employs a very rapid vibration to remove the top layer of dead skin cells. This will remove more of the dry outer layer in one treatment than we can remove with daily use of scrubs at home and does it with much less irritation. It is recommended to do a Vibraderm treatment every two to three weeks for a series of 3 to 4 treatments and then to maintain the skin with treatments every 6 to 8 weeks to maintain the benefit. The treatment enhances cell turnover, stimulates collagen production and stimulates blood flow to the surface.

Some over-the-counter products work well to exfoliate; however I would caution you not to over-do it. Most people we see who use OTC exfoliators use them to aggressively and too frequently, doing more damage than good.

Alpha hydroxy acids and beta hydroxy acids will also help with exfoliation. Both of the products can help to unclog pores, improve texture, smooth skin and give the skin a plumper, firmer appearance. Alpha hydroxy acids are effective in concentrations in at least 5-8% at a pH of 3-4 and the Beta hydroxy acids need a concentration of 1-2% at a pH of 3.

Dr. Jan Turkle

It’s Great to Exfoliate! was last modified: February 9th, 2018 by admin

Now that spring is here, we are all working in our yards and homes, getting ready for the outdoor season. It is a good time to evaluate how we are preparing the largest organ of the human body, our skin, for the coming spring and summer months. It is also a good time for us to try to repair our skin from the drying winter months. The ABC’s of good skin care are: Cleanse, Exfoliate, Hydrate and Protect. Let’s start with cleansing. We all think that we know how to cleanse the skin. A good facial cleanser should be water soluble, gentle, rinse off easily, cleanse effectively and not irritate the skin. In general bar soaps are to be avoided as the materials that cause them to retain the bar shape can be pore clogging and drying. Over scrubbing the skin can strip the skin of its protective oils and barriers, which can lead to irritation and in some cases, worsen acne. High pH levels can also create a more drying of the skin as well. The best cleansers are those with a low alcohol content to avoid drying out drier, more sensitive skin types. Detergent based cleansers will work for most skin types except those that are very dry or sensitive. Cleansers with alpha hydroxy acids or beta hydroxyl acids are helpful to provide exfoliation, but in a cleanser form, may not be in contact with the skin long enough to have a significant effect.

The Clarisonic brush, which is available for purchase at our Indianapolis and Carmel skin care center, PhasesTM, uses an ultrasonic technique to remove the dirt and dead cells in a gentle fashion. The manufacturer says it removes six times more makeup than manual cleansing. In our use in the practice, we have found it is an excellent tool to gently cleanse and remove the bacteria and debris from the skin, while avoiding abrading the skin, and maintaining an intact healthy protective barrier. Clarisonic results

In my next blog I will talk about exfoliation.

Dr. Jan Turkle

Spring Cleaning for the Skin was last modified: February 9th, 2018 by admin